Acute compartment syndrome is considered a true surgical emergency, which, if not diagnosed and treated immediately, can lead to devastating disabilities, amputation, or even death (Elliott K G B, Johnstone A J: Diagnosing acute compartment syndrome. J Bone Joint Surg 85-B:625-632, 2003). Compartment syndrome most commonly occurs following fractures of the extremities, prolonged compression of muscle compartments, localized vascular damage, or even as a result of surgical intervention (Hargens A R et al., Tissue fluid pressures: From basic research tools to clinical applications. J Orthop Res 7:902-909, 1989).
While the exact pathophysiology is still debated, a compartment syndrome is said to exist when the interstitial pressure is elevated above capillary blood pressure (Hargens A R et al., Tissue fluid states in compartment syndromes. 9th Eur Conf Microcirculation 15:108-111, 1977; Hargens A R et al., Interstitial fluid pressure in muscle and compartment syndromes in man. Microvas Res 14:1-10, 1977; Hargens A R, Mubarak S J: Current concepts in the pathophysiology, evaluation and diagnosis of compartment syndrome. Hand Clin 14:371-383, 1998). This increase in pressure results in occlusion of microarterial flow, which in turn, leads to depleted metabolic resources and impaired venous and lymphatic drainage of the affected compartment. This microvascular occlusion exacerbates the edematous process increasing interstitial pressure (ISP) and causing lymphatic collapse of the compartment; these changes eventually lead to necrosis and Volkmann's contracture of the compartmental musculature and vasculature within the affected compartment or necrosis in an affected specialized tissue or organ.
Therefore, the measurement of ISP is a valuable tool for diagnosing acute compartment syndrome. Hargens and Ballard reviewed historical and methodological approaches for measuring ISP in humans in 1995 and described the wick catheter technique, Slit Catheter Technique, Myopress Catheter, and Camino Fiber Optic Catheter. (Hargens A R, Ballard R E: Basic principles for measurement of interstitial pressure. Oper Tech Sports Med 3:237-242, 1995). All of these techniques, while slightly different in approach, sensitivity, and calibration, involve the insertion and maintenance of a catheter within the injured compartment in order to measure ISP. While transducer-tipped catheters were evaluated as the best current technology for measurement of ISP, the technological theory is still based on the invasive 1968 wick catheter (Crenshaw A G, Styf J R, Mubarak S J, Hargens A R: A new “transducer-tipped” fiber optic catheter for measuring interstitial pressures. Orthop Res 8:464-468, 1990).
Questions about the utility and prevalence of the clinical use of these catheter measurement techniques in the non-academic medical center setting have been raised. Russel, et al. described problems commonly encountered with the use of the wick catheter technique including inadequate calibration procedures and thrombosis of the catheter (Russel W L, Apyan P M, Burns R P: An electronic technique for compartment pressure measurement using the wick catheter. Surg Gyn Obst 2:173-175, 1985). Furthermore, the invasiveness of the current measurement procedure as well as the lack of physicians trained in the use of the equipment indicate the need for an easier, more reliable, and less invasive technique to measure compartment pressure.